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<br />STATIC OF NEBRASKA
<br />DXPARTNXXT OF HICALTH
<br />DlvWon of VIW SptL►ria
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<br />,h STANDARD CERTIFICATE OF DEATH
<br />DEPARTMENT OF
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<br />DlnIAU OF THE C-8U 8 ta4 711. Na ^_ —s
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<br />d1. PLACE OF DEATHi T 2. USUAL R=DENCE OF DECEASED,
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<br />October 11, 1954
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